Sunday, September 20, 2009

Every drama has protagonists and antagonists, the audience can choose their own sides. Below we see Holly Maag, local attorney and chair person of CSA 36, listening intently to the allegations of a local Belgian restaurateur, who blamed the whole evening on the Town Crier.

Pete Capparelli, former CSA 36 chair, smiles graciously and listens to Bill Brown posing questions to ICRC about its implementation of the recreation contract with Riverside County. The county pays ICRC the costs of providing and managing local recreational programs. "Hey, he's not asking us."

Speaking for ICRC is the always deferential and eloquent local realter Vic Sirkin. However, he and Chair person Chris Singer, let Jim Ludy answer the bulk of the financial questions. Singer, who was offended by Brown's tone of voice, said "I don't know the answer, I'm just a volunteer and an innkeeper!"

The final player in Thursday's melodrama was Bill Brown, CSA Operations Manager for Riverside County's Economic Development Agency. Despite Brown stating he received several phone calls asking questions about the operations, several people continued to insist that the Town Crier stories created the rift on the ICRC board and were responsible for focusing Brown's attention on Idyllwild and attracting him to this meeting, his second trip to Idyllwild in a month. Do you wonder if County personnel get "per diem" expenses when they come here?

More than 50 people attended the joint County Service Area (CSA) 36 and Idyllwild Community Recreation Council (ICRC) meeting with Bill Brown, CSA operations manager for Riverside County's EDA. People from Idyllwild and Pine Cove were out to hear the discussion.

Annamarie Padula, Pine Cove resident, raises questions about the role of Pine Cove residents in the planning of the community center, especially if they will be invited to share the long-term operational costs.

Matt Kraemer, Idyllwild School principal, spoke out supporting the recreational programs success in offering children's activites rather than simply roaming the streets.Robert Priefer explains his preliminary ideas about the use of the community center site and how planning might proceed.Many local celebrities were in audience, below we see noted local blogger Conor O'Farrell sans chapeau, but sill able to express and to pontificate to the audience's awe. Bravo!! Encore!!

Wednesday, September 16, 2009

Welcome to JP’s blog. This is where we take off the gloves and the typing gets worse.

Again I have to stress, the current bondholders were the principal whiners to the bankruptcy judge. Despite VHS’ overall improving finances, the monthly results were still losses. The bondholders urged the judge to revoke bankruptcy protection and let the creditors loose on the district.

Basically, the terms that were revealed Wednesday, simply shift the debt to PHH from VHS. That is a simplification, but not far from the final solution. How will PHH pay its new debt if the hospital is still losing money or barely profitable?

Doctor after doctor spoke last night. They all implored the board to approve the deal and let them protect the valley patients by owning the hospital. Nearly all made to sure to mention the times they worked 18 or 24 hours in the hospital.

Nearly every doctor posed a binary choice. Either sell the hospitals to them or let them be sold to cover the “Wall Street bondholders” threats!!

This conjured images of men in waxy moustaches and top hats sitting in clubs and dividing up the world. If these robber barons sold the hospitals they would be closed.

Why would the buyers pay millions for hospitals and then close them? I guess to renovate Hemet Medical Center into a high rise hotel or condominium unit.

The other threat to the community was the looming shadow of Kaiser — a single payer healthcare. Dr. Fred White offered that connection to national politics. By the way, they also feared Kaiser would limit their access to hospitals.

Rejecting PHH was tantamount to selling to Kaiser Permanente, who has not made any informal bids. And that means not enough beds.

It’s true southwest Riverside County has a lower bed per capita ratio than the rest of the state. But HVMC and MVMC have a lot of vacant beds available, which aren’t filled very often.

Which brings one back to how will the doctors afford this deal? Dr. Alex Denes, the PHH spokesman, said 130 physicians have “signed up.” He did say PHH would release a list of members after the agreement is accepted.

But he did indicate that only 54 of them have made a financial commitment.

So back to the profit margin, Denes says PHH will save $300,000 monthly because they won’t have the cost of bankruptcy on its back. That still not enough for the secured bondholders.

The profits have to come from increased revenue because PHH has agreed to keep substantially all of the current employees. Of course, “substantially” was later defined to mean “most”.

Denes did announce that PHH has aligned itself with Catholic Healthcare West, the group that manages St. Bernadine Medical Center in San Bernardino. He said this will help PHH offer expanded services such as cardiac and orthopedic.

Meanwhile existing services such as emergency room and obstetrics will stay open for at least 5 years; but only “to the extent that it is commercially reasonable and viable to do so in the context of the then applicable health care environment.”

I’m not sure what the “health care environment” will be over the next five years, but I bet the economic environment will continue to make it difficult and costly for people to get adequate care. So the demand for emergency facilities will grow.

Denes suggested that PHH might establish some neighborhood clinics to treat non-severe cases and try to shift some demand away from the emergency rooms.

When asked if Idyllwild might be a location because of its distance from HVMC, he conceded the possibility. But PHH has not done any planning to enable them to say with authority where these clinics might be located.

Two final thoughts that may affect the deal in the long term:

1. There is talk and some action in halls of Congress to limit Medicare payments to physician owned hospitals. That would have a real effect on revenues — negative. Dr. Cherry, VHS chairman of the board, says that will never happen.

2. If the proposed new hospital were completed, how would that affect admissions to HVMC and what about the eventual costs to rehab it for seismic strengthening.

But on doctor was so cocky he said he was willing to invest his life savings in this deal. Right.t.t.t.t.t

Thursday, September 10, 2009

Last night, I watch the first game of the three game series for the Idyllwild Softball Championship.

Ajax won 13-12 or 14-13, but the game went 9 innings and Kirsten Torrez his the game winning homerun in the top of the ninth (guess she had a long drive back to Hemet and didn't want to do it in the dark). Pacific Slope was behind much of the game, but tied it with 3 runs in the bottom of the seventh.

No score in the 8th. With two out and none on base, one strike, Torrez dropped her shoulder and popped it up. The ball kept going higher, the leftfielder turned and ran toward the fence, the ball kept going further. the leftfielder stopped, and the ball fell on the bank beyond the fence.